Subramony C, Herrera G A, Turbat-Herrera E A
Department of Pathology, University of Mississippi, Jackson.
Arch Pathol Lab Med. 1993 Oct;117(10):1036-42.
Hepatobiliary cystadenoma is a rare hepatic lesion characterized by a multiloculated cyst lined by cuboidal or columnar epithelial cells. Four cases of hepatobiliary cystadenoma with mesenchymal stroma (HCMS) and one case of hepatobiliary cystadenoma with intracystic epithelial component were studied by light microscopy, immunohistochemical methods, and electron microscopy. Similar studies were conducted on six fetal gallbladder tissues, representing the biliary tree, and two adult ovarian tissues. By light microscopy, the columnar epithelium of the five cases of hepatobiliary cystadenoma was similar to the epithelium of the developing gallbladder. The spindle cell stroma of the HCMS and the subepithelial spindle cells of the developing gallbladders showed similar reactivity to smooth-muscle actin. Vimentin reactivity was strongly positive in the stroma of the HCMS, and in the fetal gallbladders it was only noted in the subepithelial spindle cells of the 15-week gestation fetal gallbladder tissues. By electron microscopy, the epithelium lining the hepatic lesions showed characteristic gastrointestinal features and was identical to the epithelia lining the embryonic gallbladders. Furthermore, the mesenchymal stroma of the HCMS recapitulated the features found in subepithelial tissues in developing gallbladders. Although the ovarian stroma resembled the stroma of the HCMS by light microscopy, the immunohistochemical reactions and the electron microscopic studies showed dissimilarities. This study supports the hypothesis that the hepatobiliary cystadenomas arise from ectopic embryonic tissues destined to form the adult gallbladder.
肝胆管囊腺瘤是一种罕见的肝脏病变，其特征为有由立方上皮细胞或柱状上皮细胞衬里的多房囊肿。对4例伴有间充质基质的肝胆管囊腺瘤（HCMS）和1例伴有囊内上皮成分的肝胆管囊腺瘤进行了光镜检查、免疫组化方法及电镜检查。对代表胆管树的6例胎儿胆囊组织和2例成人卵巢组织进行了类似研究。光镜下，5例肝胆管囊腺瘤的柱状上皮与发育中胆囊的上皮相似。HCMS的梭形细胞基质和发育中胆囊的上皮下梭形细胞对平滑肌肌动蛋白显示出相似的反应性。波形蛋白反应性在HCMS的基质中呈强阳性，而在胎儿胆囊中，仅在妊娠15周胎儿胆囊组织的上皮下梭形细胞中观察到。电镜下，肝脏病变内衬的上皮表现出典型的胃肠道特征，与胚胎胆囊内衬的上皮相同。此外，HCMS的间充质基质重现了发育中胆囊上皮下组织的特征。虽然光镜下卵巢基质与HCMS的基质相似，但免疫组化反应和电镜研究显示存在差异。本研究支持肝胆管囊腺瘤起源于注定要形成成人胆囊的异位胚胎组织这一假说。
